What is nurse burnout?

While it’s not considered a medical condition, the American Psychological Association defines burnout as “physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others.”¹

Even as the term is widely adopted by professionals in all industries, “burnout” was first used in 1975 by psychologist Herbert J. Freudenberger to describe clinical workers with heavy caseloads. Nurses in particular have always faced stressful, fast-paced work environments but the COVID-19 pandemic brought an onslaught of traumatic experiences and risky situations. On top of the pandemic, the U.S. nursing shortage, which began in 2012,² worsened staffing issues leading to further exhaustion and turnover.

Because of the inherent high risk for burnout in nurses, it’s important when working in the profession to know what warning signs and symptoms to look for, the risks associated with nurse burnout as well as methods for avoiding the causes of burnout.

Causes of nurse burnout

One of the first steps to improving your well-being is to understand some of the factors contributing to nurse burnout. From a philosophical perspective, the Maslach Burnout Inventory (MBI) study found that burnout develops when there is a prolonged mismatch between an employee and one or more of the following:

• Workload - such as a high volume of work and/or low staffing
• Control – being micromanaged or not having enough autonomy
• Reward – inadequate pay, promotions, recognition
• Community – feeling isolated, missing community with your colleagues
• Fairness – processes that lead to privileges of some groups or individuals over others
• Values – no stated mission/vision or feeling that job responsibilities aren’t matching with values

But what concrete factors cause nurse burnout? The following list presents some clear suggestions of what could lead to burnout. Obviously some of these issues are more easily dealt with than others while some would require a certain level of effort from your administrative or management team.

Long hours

It’s no secret that nurses work a lot. Many nursing schedules are three days of twelve hour shifts. While it might seem nice to only have a three-day week, those shifts are exhausting and require more time off to recover from. Plus, plenty of hospital workers work overnight, forcing them to rest during the day and generally miss out on time with family and friends.

Lack of sleep

Additionally, studies have found that people who work rotating shifts (i.e. workers like nurses that sometimes work day shifts, sometimes work night shifts rather than having a routine 9-5 schedule) have significantly lower levels of serotonin, a hormone that helps regulate sleep. This shift work sleep disorder causes sufferers to have trouble sleeping, sleep on average one to four hours fewer than day workers, feel severely tired and get poor quality sleep. Low levels of serotonin are also associated with other conditions such as anger, depression and anxiety.³

High-Stress Environment

Whether you’re working as a nurse in an emergency room, inpatient hospital department, or a private clinic, the job can be extremely stressful. That’s only to be expected when you’re tasked with administering medications, collecting specimens and information, taking orders from a number of doctors all while trying to provide a positive experience for patients.

Lack of Support

The strain of understaffing can be a big contributor to nurse burnout. In 2018 the average age for an RN was found to be 50 years old, signaling an incoming large wave of retirements within the field.⁴ That means not only fewer nurses but fewer nurses with legacies of experience who can serve as naturally appointed leaders to look out for and guide newer nurses. Additionally, nurses often cite feeling a lack of support from administrators for not hiring enough or to reduce understaffing or otherwise working to improve conditions.

Emotional Strain from Patient Care

Nurses encounter patients at some of the most uncomfortable, scary, or stressful times in their lives. Additionally, due to long-enforced gender norms, people expect female nurses to be especially comforting and accommodating, even when it’s not a part of their job. Depending on their work environment, nurses also come into contact with death much more often than most people. This can get super overwhelming and nearly impossible to bear.

Dangers of Nurse Burnout

The negative outcomes of nurse burnout fall like a line of dominos. When conditions lead nurses to feel burnout they in turn might leave the organization or profession as a whole, further causing understaffing and more burnout. In one survey of nurses, 32% reported burnout as contributing to them leaving their jobs.⁵ Studies also show that burnout can lead to a decline in patient safety, deterioration of teamwork climate, patient dissatisfaction and increased patient and family complaints.⁶

How Nurses Can Prevent Burnout

Signs and symptoms of nurse burnout

In a scientific sense, burnout can be identified and measured by Maslach’s theory. Critically, Maslach’s theory of burnout marks it as a condition distinct from stress. To measure the condition she developed the Maslach Burnout Inventory, which is still widely used today. The theory posits that burnout is characterized primarily by:⁷

• Feeling emotionally drained (emotional exhaustion);
• Adverse and cynical detachment from patients, clients and colleagues (depersonalisation);
• A lack of confidence in being able to do one’s job (reduced personal accomplishment)

How to prevent nurse burnout

There are some concrete ways individuals, managers and employers can help reduce nurse burnout.

Set boundaries and create routines

Try not to bring work home with you. Create routines around leaving work so that you can shake off the day and approach your personal time fresh. Even if you’re working a rotating shift schedule you can try to plan ahead to make sure you have time to see family and friends and fit in necessary activities like exercise, eating well and sleep.

Develop strong relationships with coworkers

As much as possible, befriend your coworkers. Building solid relationships at work will give you people to vent to, solve problems with, and will make good comrades when you need to ask managers for improvements. Plus, if you enjoy your coworkers it will hopefully make work a more enjoyable place to be.

Seek out additional support

Therapists or counselors are great resources for working through difficult situations whether personal or professional. Some therapists might even specialize in psychological care for medical workers and be able to provide good advice for dealing with feelings of burnout.

Try something new

Whether you want to take a vacation (make use of your PTO) or just try a new restaurant, keep switching things up.

Strengthen your career and avoid burnout

Another key way to refresh your life? Try learning something new. A new degree in nursing could reignite your excitement for the field and also equip you to earn higher salaries, work better schedules and pursue a speciality area. Check out Oklahoma City University’s online programs for the RN-BSN, MSN and RN-MSN. If you’re excited at the prospect of a nursing degree, schedule a call with one of our Admissions Advisors.